ATI RN
Client Safety Alternatives to Restraints Quizlet Questions
Question 1 of 5
A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which admission orders should the nurse implement first?
Correct Answer: C
Rationale: The correct answer is C: Place in respiratory/secretion precautions. This is the priority because meningococcal meningitis is spread through respiratory secretions, so isolating the child will prevent transmission. A: Institute seizure precautions is important but not the first priority. B: Monitoring neurologic status is essential but not the initial action. D: Administering antibiotics is crucial, but isolating the child to prevent spread takes precedence.
Question 2 of 5
Two adult siblings are caring for their ill mother, who requires 24-hour care: she needs assistance with feeding, bathing, and toileting. One of the siblings takes time to exercise after work. The other sibling goes directly to the mother's home before and after work each day. The nurse recognizes that people may react differently to the same stressors depending on various factors. What are some of these factors? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Amount of perceived stress. This is because individuals may react differently to stressors based on how they perceive the level of stress they are experiencing. Factors such as previous experiences, personality, and support systems can influence how stress is perceived. Hair color (B) and skin type (D) are not relevant factors in how individuals react to stress. Individual coping skills (C) are important, but they are more about how individuals manage stress rather than how they initially perceive it.
Question 3 of 5
Oral temperature, best
Correct Answer: B
Rationale: The correct answer is B (Under tongue) for taking oral temperature. This method is widely used and recommended for its accuracy and convenience. Placing the thermometer under the tongue ensures direct contact with saliva, providing a more accurate reflection of core body temperature. Taking temperature in the gums (A) may not provide as reliable results due to variations in saliva production and positioning. No information is given for choices C and D.
Question 4 of 5
A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct: 1. Address the issue professionally and objectively. 2. Focus on unit expectations rather than personal attacks. 3. Create an opportunity for open dialogue and clarification. 4. Set a constructive tone for resolving the conflict. Summary of why other choices are incorrect: B. Involves hearsay and personal attacks. C. Threatening without a resolution strategy. D. Accusatory and judgmental approach.
Question 5 of 5
The nurse is developing a plan of care for a client with disturbed body image. Which interventions would the nurse most likely include in the plan? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A (Establish rapport with the client) because building a trusting relationship is essential in addressing disturbed body image. By establishing rapport, the nurse can create a safe environment for the client to express their feelings and concerns. Choice B (Role model appropriate behavior) may not directly address the client's distorted body image issues and might not be as effective as building rapport. Choice C (Encourage client to make positive self-statements) may be helpful in boosting self-esteem, but it may not address the underlying causes of the disturbed body image. Choice D (Assist the client in accepting responsibility for own actions) is not directly related to addressing disturbed body image and may not be as effective as building rapport in this context.